Description of an advanced practice nursing consultative model to reduce restrictive siderail use in nursing homes

Researchers have demonstrated that the use of physical restraints in nursing homes can be reduced, particularly where advanced practice nurses (APNs) are utilized. We examined the link between APN practice, siderail reduction, and the costs of siderail alternatives in 273 residents in four Philadelp...

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Bibliographic Details
Published in:Research in nursing & health 2007-04, Vol.30 (2), p.131-140
Main Authors: Wagner, Laura M., Capezuti, Elizabeth, Brush, Barbara, Boltz, Marie, Renz, Susan, Talerico, Karen A.
Format: Article
Language:English
Subjects:
Accidental Falls - economics
Accidental Falls - prevention & control
Activities of Daily Living
Advanced nurse practitioners
advanced practice nurses
Aged
Aged, 80 and over
bed-related falls
Beds
Biological and medical sciences
Cognition Disorders - nursing
Cost-Benefit Analysis
Costs
Elderly people
Falls
Female
Geriatric Assessment - methods
Geriatric Nursing - organization & administration
Health participants
Health Promotion - organization & administration
Humans
Male
Medical sciences
Miscellaneous
Models, Nursing
Nurse Clinicians - organization & administration
Nurse Practitioners - organization & administration
Nurses
Nursing
Nursing Assessment - organization & administration
Nursing Evaluation Research
Nursing Homes
Patient safety
Philadelphia
Physical restraints
Prevention and actions
Professional practice
Public health. Hygiene
Public health. Hygiene-occupational medicine
Restraint, Physical - utilization
Restraints
Risk Assessment - organization & administration
safety
Safety Management - organization & administration
siderails
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Summary:Researchers have demonstrated that the use of physical restraints in nursing homes can be reduced, particularly where advanced practice nurses (APNs) are utilized. We examined the link between APN practice, siderail reduction, and the costs of siderail alternatives in 273 residents in four Philadelphia nursing homes. The majority of participants were cognitively and physically impaired with multiple co‐morbidities. APNs recommended a total of 1,275 siderail‐alternative interventions aimed at reducing fall risk. The median cost of siderail alternatives to prevent falls per resident was $135. Residents with a fall history experienced a significantly higher cost of recommendation compared to non‐fallers. Findings suggest that an APN consultation model can effectively be implemented through comprehensive, individualized assessment without incurring substantial costs to the nursing home. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 131–140, 2007
ISSN:0160-6891
1098-240X
DOI:10.1002/nur.20185